Caracterización del ataque cerebro vascular isquémico en una clínica de tercer nivel de la ciudad de Barranquilla

El ataque cerebro vascular de origen isquémico representa un problema de salud pública a nivel mundial expresándose con alta carga en desenlaces de mortalidad, deterioro de la capacidad funcional y calidad de vida. Las investigaciones están centradas en determinar y comprender los factores de riesgo...

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Autores:: Gaona Pineda, Henry Leonardo

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Fecha de publicación:: 2023

Institución:: Universidad Libre

Repositorio:: RIU - Repositorio Institucional UniLibre

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dc.title.spa.fl_str_mv	Caracterización del ataque cerebro vascular isquémico en una clínica de tercer nivel de la ciudad de Barranquilla
title	Caracterización del ataque cerebro vascular isquémico en una clínica de tercer nivel de la ciudad de Barranquilla
spellingShingle	Caracterización del ataque cerebro vascular isquémico en una clínica de tercer nivel de la ciudad de Barranquilla Ataque cerebrovascular Factores de riesgo Severidad Terapia de reperfusión endovascular Infección por SARS CoV-2 Cerebrovascular attack Risk factors Severity Endovascular reperfusion therapy SARS CoV-2 infection Accidente cerebrovascular Interpretación estadística de datos Isquemia
title_short	Caracterización del ataque cerebro vascular isquémico en una clínica de tercer nivel de la ciudad de Barranquilla
title_full	Caracterización del ataque cerebro vascular isquémico en una clínica de tercer nivel de la ciudad de Barranquilla
title_fullStr	Caracterización del ataque cerebro vascular isquémico en una clínica de tercer nivel de la ciudad de Barranquilla
title_full_unstemmed	Caracterización del ataque cerebro vascular isquémico en una clínica de tercer nivel de la ciudad de Barranquilla
title_sort	Caracterización del ataque cerebro vascular isquémico en una clínica de tercer nivel de la ciudad de Barranquilla
dc.creator.fl_str_mv	Gaona Pineda, Henry Leonardo
dc.contributor.advisor.none.fl_str_mv	Vargas Manotas, José Varela Prieto, Lourdes
dc.contributor.author.none.fl_str_mv	Gaona Pineda, Henry Leonardo
dc.subject.spa.fl_str_mv	Ataque cerebrovascular Factores de riesgo Severidad Terapia de reperfusión endovascular Infección por SARS CoV-2
topic	Ataque cerebrovascular Factores de riesgo Severidad Terapia de reperfusión endovascular Infección por SARS CoV-2 Cerebrovascular attack Risk factors Severity Endovascular reperfusion therapy SARS CoV-2 infection Accidente cerebrovascular Interpretación estadística de datos Isquemia
dc.subject.subjectenglish.spa.fl_str_mv	Cerebrovascular attack Risk factors Severity Endovascular reperfusion therapy SARS CoV-2 infection
dc.subject.lemb.spa.fl_str_mv	Accidente cerebrovascular Interpretación estadística de datos Isquemia
description	El ataque cerebro vascular de origen isquémico representa un problema de salud pública a nivel mundial expresándose con alta carga en desenlaces de mortalidad, deterioro de la capacidad funcional y calidad de vida. Las investigaciones están centradas en determinar y comprender los factores de riesgo la presentación clínica y la eficacia de las respuestas de tratamientos endovasculares específicos para implementar medidas de detección temprana que garanticen una intervención oportuna y mejoren el pronóstico a largo plazo. Objetivo: Realizar una caracterización de los pacientes con ataque cerebro vascular isquémico valorados en la unidad de neurología de la Clínica Misericordia Internacional en la ciudad de Barranquilla Colombia, durante el año comprendido entre el 2021 hasta febrero de 2023. Metodología: Estudio descriptivo de corte transversal. Se incluyeron mayores de 18 años con diagnóstico de enfermedad cerebrovascular isquémica. La información se recolectó de las historias clínicas y se empleó estadística descriptiva para analizar los datos. Resultados: 287 pacientes con edad media de 68,12 DE: ± 13,56,179 (62%) Hombres, 217(75%) con hipertensión arterial y 68 (23,7) con diabetes mellitus tipo 2 como factor de riesgo más frecuente. El compromiso de la circulación anterior fue de 250 (87,1%) comparado con 37 (12,8%) con compromiso de circulación posterior. Se realizo TC en 272 (83%) y RMN en 176 (61,3%). La severidad al ingreso se valoró en todos los pacientes con la escala (NIHSS), con una mediana (RIC): 7 (3-13). Se registró mortalidad intrahospitalaria en 19 (6,6%) y se confirmó la infección por SARS CoV-2 en 3 (1%). el tiempo desde del inicio de síntomas y el ingreso estuvo por fuera de ventana de las terapias de reperfusión estándar y extendidas en un 98.3%. Solo 4 (1.4%) recibió terapia endovascular con fibrinolisis. Solo 1 (0.34%) fue llevado a trombectomía mecánica únicamente y solo solo 1 (0.34%) recibió ambos procedimiento de reperfusión Conclusión: La atención e intervención oportuna del ACV isquémico es un proceso complejo que depende principalmente del tiempo. La severidad en las escalas de estratificación se correlaciona con la capacidad de predecir mortalidad. así mismo como la terapia endovascular en los tiempos de ventana establecidos impacta en desenlaces de mortalidad intrahospitalaria.
publishDate	2023
dc.date.created.none.fl_str_mv	2023-06
dc.date.accessioned.none.fl_str_mv	2024-02-06T14:08:21Z
dc.date.available.none.fl_str_mv	2024-02-06T14:08:21Z
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dc.type.local.spa.fl_str_mv	Tesis de Especialización
dc.type.driver.spa.fl_str_mv	info:eu-repo/semantics/bachelorThesis
dc.identifier.uri.none.fl_str_mv	https://hdl.handle.net/10901/28369
url	https://hdl.handle.net/10901/28369
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ACV y covid-19: una revisión de los estudios observacionales publicados en época de pandemia. Acta Neurológica Colomb. 2020;36(2):63–74 Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol. 2021 Oct;20(10):795–820 Campbell BCV, De Silva DA, Macleod MR, Coutts SB, Schwamm LH, Davis SM, et al. Ischaemic stroke. Nat Rev Dis Prim [Internet]. 2019;5(1). Available from: http://dx.doi.org/10.1038/s41572-019-0118-8 WHO. WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020 [ Internet]. 2020. Available from: https://www.who.int/directorgeneral/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefingon-covid-19 --11-march-2020 Kuitunen I, Ponkilainen VT, Launonen AP, Reito A, Hevonkorpi TP, Paloneva J, et al. The effect of national lockdown due to COVID-19 on emergency department visits. 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J Clin Neurol. 2021;17(1):63–9 Kleindorfer DO, Towfighi A, Chaturvedi S, Cockroft KM, Gutierrez J, Lombardi-Hill D, et al. 2021 Guideline for the prevention of stroke in patients with stroke and transient 64 ischemic attack; A guideline from the American Heart Association/American Stroke Association. Stroke. 2021. 364–467 p Krishnamurthi R V., Feigin VL. Global Burden of Stroke [Internet]. Seventh Ed. Stroke. Elsevier Inc.; 2022. 163-178.e2 p. Available from: https://doi.org/10.1016/B978-0-323- 69424-7.00014-4 Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke. Vol. 50, Stroke. United States; 2019. p. e344–418 Urdaneta AE, Bhalla P. Cutting Edge Acute Ischemic Stroke Management. Emerg Med Clin North Am [Internet]. 2019;37(3):365–79. Available from: https://doi.org/10.1016/j.emc.2019.03.001 Markus HS, Michel P. Treatment of posterior circulation stroke: Acute management and secondary prevention. Int J stroke Off J Int Stroke Soc. 2022 Aug;17(7):723–32 Salerno A, Strambo D, Nannoni S, Dunet V, Michel P. Patterns of ischemic posterior circulation strokes: A clinical, anatomical, and radiological review. Int J stroke Off J Int Stroke Soc. 2022 Aug;17(7):714–22 Hoyer C, Szabo K. Pitfalls in the Diagnosis of Posterior Circulation Stroke in the Emergency Setting. Front Neurol. 2021; 12:682827 Nouh A, Remke J, Ruland S. Ischemic posterior circulation stroke: a review of anatomy, clinical presentations, diagnosis, and current management. Front Neurol. 2014; 5:30 Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, et al. 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Stroke. 2021 Jun;52(6):1995–2004 Howard G, Lackland DT, Kleindorfer DO, Kissela BM, Moy CS, Judd SE, et al. Racial differences in the impact of elevated systolic blood pressure on stroke risk. JAMA Intern Med. 2013 Jan;173(1):46–51 Hu G, Sarti C, Jousilahti P, Peltonen M, Qiao Q, Antikainen R, et al. The impact of history of hypertension and type 2 diabetes at baseline on the incidence of stroke and stroke mortality. Stroke. 2005 Dec;36(12):2538–43 Meschia JF, Bushnell C, Boden-Albala B, Braun LT, Bravata DM, Chaturvedi S, et al. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014 Dec;45(12):3754–832 Choreño-Parra JA, Carnalla-Cortés M, Guadarrama-Ortíz P. Enfermedad vascular cerebral isquémica: revisión extensa de la bibliografía para el médico de primer contacto TT - Ischemic cerebrovascular disease: extensive review of the literature for the first contact physician. Med interna Méx [Internet]. 2019;35(1):61–79. Available from: http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp%0Apid=S0186- 48662019000100061 Wasser K, Weber-Krüger M, Jürries F, Liman J, Hamann GF, Kermer P, et al. The cardiac diagnostic work-up in stroke patients-A subanalysis of the Find-AFRANDOMISED trial. PLoS One. 2019;14(5): e0216530 Terré R. [Oropharyngeal dysphagia in stroke: diagnostic and therapeutic aspects]. Rev Neurol. 2020 Jun;70(12):444–52 Demir Unal E. Clinico-topographic evaluation of anterior versus posterior acute ischemic 67 stroke and correlation with early mortality-based scale prediction. eNeurologicalSci. 2023 Jun; 31:100458 Wang J, Chaudhry SA, Tahsili-Fahadan P, Altaweel LR, Bashir S, Bahiru Z, et al. The impact of COVID-19 on acute ischemic stroke admissions: Analysis from a communitybased tertiary care center. J stroke Cerebrovasc Dis Off J Natl Stroke Assoc. 2020 Dec;29(12):105344 Pujol-Lereis VA, Flores A, Barboza MA, Abanto-Argomedo C, Amaya P, Bayona H, et al. COVID-19 Lockdown Effects on Acute Stroke Care in Latin America. J stroke Cerebrovasc Dis Off J Natl Stroke Assoc. 2021 Sep;30(9):105985 Lees KR, Bluhmki E, von Kummer R, Brott TG, Toni D, Grotta JC, et al. Time to treatment with intravenous alteplase and outcome in stroke: an updated pooled analysis of ECASS, ATLANTIS, NINDS, and EPITHET trials. Lancet (London, England). 2010 May;375(9727):1695–703 Saver JL. Time is brain--quantified. Stroke. 2006 Jan;37(1):263–6 Grigoryan M, Haussen DC, Hassan AE, Lima A, Grossberg J, Rebello LC, et al. Endovascular Treatment of Acute Ischemic Stroke Due to Tandem Occlusions: Large Multicenter Series and Systematic Review. Cerebrovasc Dis. 2016;41(5–6):306–12
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spelling	Vargas Manotas, JoséVarela Prieto, LourdesGaona Pineda, Henry LeonardoBarranquilla2024-02-06T14:08:21Z2024-02-06T14:08:21Z2023-06https://hdl.handle.net/10901/28369El ataque cerebro vascular de origen isquémico representa un problema de salud pública a nivel mundial expresándose con alta carga en desenlaces de mortalidad, deterioro de la capacidad funcional y calidad de vida. Las investigaciones están centradas en determinar y comprender los factores de riesgo la presentación clínica y la eficacia de las respuestas de tratamientos endovasculares específicos para implementar medidas de detección temprana que garanticen una intervención oportuna y mejoren el pronóstico a largo plazo. Objetivo: Realizar una caracterización de los pacientes con ataque cerebro vascular isquémico valorados en la unidad de neurología de la Clínica Misericordia Internacional en la ciudad de Barranquilla Colombia, durante el año comprendido entre el 2021 hasta febrero de 2023. Metodología: Estudio descriptivo de corte transversal. Se incluyeron mayores de 18 años con diagnóstico de enfermedad cerebrovascular isquémica. La información se recolectó de las historias clínicas y se empleó estadística descriptiva para analizar los datos. Resultados: 287 pacientes con edad media de 68,12 DE: ± 13,56,179 (62%) Hombres, 217(75%) con hipertensión arterial y 68 (23,7) con diabetes mellitus tipo 2 como factor de riesgo más frecuente. El compromiso de la circulación anterior fue de 250 (87,1%) comparado con 37 (12,8%) con compromiso de circulación posterior. Se realizo TC en 272 (83%) y RMN en 176 (61,3%). La severidad al ingreso se valoró en todos los pacientes con la escala (NIHSS), con una mediana (RIC): 7 (3-13). Se registró mortalidad intrahospitalaria en 19 (6,6%) y se confirmó la infección por SARS CoV-2 en 3 (1%). el tiempo desde del inicio de síntomas y el ingreso estuvo por fuera de ventana de las terapias de reperfusión estándar y extendidas en un 98.3%. Solo 4 (1.4%) recibió terapia endovascular con fibrinolisis. Solo 1 (0.34%) fue llevado a trombectomía mecánica únicamente y solo solo 1 (0.34%) recibió ambos procedimiento de reperfusión Conclusión: La atención e intervención oportuna del ACV isquémico es un proceso complejo que depende principalmente del tiempo. La severidad en las escalas de estratificación se correlaciona con la capacidad de predecir mortalidad. así mismo como la terapia endovascular en los tiempos de ventana establecidos impacta en desenlaces de mortalidad intrahospitalaria.Universidad Libre Seccional Barranquilla -- Facultad de Ciencias de la Salud -- Especialización en Medicina InternaIschemic cerebrovascular attack represents a public health problem worldwide, expressing itself with a high burden in mortality outcomes, deterioration of functional capacity and quality of life. Research is focused on determining and understanding risk factors, clinical presentation, and the efficacy of responses to specific endovascular treatments to implement early detection measures that guarantee timely intervention and improve long-term prognosis. Objective: To characterize patients with ischemic stroke assessed in the neurology unit of the Misericordia International Clinic in the city of Barranquilla Colombia during the year from 2021 to February 2023. Methodology: Descriptive cross-sectional study. People over 18 years of age with a diagnosis of ischemic cerebrovascular disease were included. The information was collected from the medical records and descriptive statistics were used to analyze the data. Results: 287 patients with a mean age of 68.12 SD: ± 13,56,179 (62%) Men, 217 (75%) with arterial hypertension and 68 (23.7) with type 2 diabetes mellitus as the most frequent risk factor. Anterior circulation involvement was 250 (87.1%) compared to 37 (12.8%) with posterior circulation involvement. CT was performed in 272 (83%) and MRI in 176 (61.3%). Severity on admission was assessed in all patients with the scale (NIHSS), with a median (IQR): 7 (3-13. In-hospital mortality was recorded in 19 (6.6%) and SARS CoV-2 infection was confirmed in 3 (1%). the time from the onset of symptoms to admission was outside the window of standard and extended reperfusion therapies by 98.3%. Only 4 (1.4%) received endovascular therapy with fibrinolysis. Only 1 (0.34%) underwent mechanical thrombectomy alone and only 1 (0.34%) received both reperfusion procedures. Conclusion: Care and timely intervention of ischemic stroke is a complex process that depends mainly on time. 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Caracterización del ataque cerebro vascular isquémico en una clínica de tercer nivel de la ciudad de Barranquilla

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